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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleBrain

Changes in Integrity of Normal-Appearing White Matter in Patients with Moyamoya Disease: A Diffusion Tensor Imaging Study

H. Jeong, J. Kim, H.S. Choi, E.S. Kim, D.-S. Kim, K.-W. Shim and S.-K. Lee
American Journal of Neuroradiology November 2011, 32 (10) 1893-1898; DOI: https://doi.org/10.3174/ajnr.A2683
H. Jeong
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J. Kim
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H.S. Choi
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E.S. Kim
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D.-S. Kim
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K.-W. Shim
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S.-K. Lee
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    Fig 1.

    ROI method for ADCCS and FACS measurement. Round ROIs (60 mm3) were drawn on the EPI scan of the b = 0 step at the level of the centrum semiovale, followed by automatic overlaying onto the coregistered FA and ADC images.

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    Fig 2.

    Primary MMD in a 6-year-old girl. A–C, MRA images showed asymmetric MRA cores and stages between both hemispheres (Rt., stage III; Lt., stage II). TTP (D) and CBV (E) maps demonstrated asymmetric hemodynamic status, in which the Rt. hemisphere showed more delayed TTP and increased CBV. Diffusion-weighted image (b = 1000; F) and a FLAIR image (G) did not show any abnormalities. H, ADC map, right side ADCCS (836.3 mm2/s) was higher than left side ADCCS (779.8 mm2/s). I, FA map, right side FACS (0.438 × 10−3) was lower than left side FACS (0.487 × 10−3).

Tables

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    Table 1:

    Clinical information and findings for TTP status, degree of supraclinoid ICA or MCA stenosis, and rCBV pattern

    No.SexAge (yr)Clinical SymptomH-TTPdelayedMRA ScorearCBV in H-TTPdelayed
    Rt.Lt.
    1F5TIA (Lt. HP)Rt.21Increased
    2M6TIA (Rt. HP)Lt.34Increased
    3F6TIA (Rt. HP)Lt.14Increased
    4F6HeadacheRt.43Increased
    5F6TIA (Rt. HP)Rt.31Increased
    6F7TIA (Rt. HP)Lt.34Increased
    7F7SeizureLt.12Increased
    8F8TIA (Rt. HP)Lt.45Increased
    9F8HeadacheLt.23Increased
    10F8Family historyLt.34Increased
    11M10TIA (Lt. HP)Lt.45Increased
    12F10TIA (Rt. HP)Lt.23Increased
    13M11TIA (Rt. HP)Lt.23Increased
    14M12HeadacheLt.12Increased
    15F12TIA (Lt. HP)Rt.51Increased
    16M13HypogonadismLt.13Increased
    17F13TIA (Lt. HP)Lt.23Increased
    18F13TIA (Rt. HP)Lt.35Increased
    19F15TIA (Rt. HP)Lt.35Increased
    20F15TIA (Lt. HP)Rt.42Increased
    • Note:—HP indicates hemisphere

    • ↵a MRA score is presented as the sum of anterior cerebral artery, MCA, posterior cerebral artery, and distal ICA using the MRA scoring system proposed by Houkin et al.21

    • View popup
    Table 2:

    Measured diffusion characteristics in patient and control groups

    PatientPatient GroupControl Group
    H-TTPdelayedH-TTPshorterH-TTPdelayedH-TTPshorter
    FACSADCCSFACSADCCSFACSADCCSFACSADCCS
    1438837.5486831.7420.7797.6415.7788.2
    2445.4783.8408814.7431.3951.5426829
    3438836.3487779.8464.2781.1454.7807.9
    4505.6754.4445.1795.5513.3749.4475.6769.3
    5458.4934.1528.2814.3454.5830.9448.2804.5
    6388864399.9862.6486.4738.8478.9743.4
    7406.4860.8391.3863.4506.4719.2484.3709.1
    8463.8767425.4765.9472.2754.7476730.2
    9464.2759.1425.9792.9468.5773.3488.4765.3
    10502.6748.2471.2741.6501.2728.8505.1717.4
    11521.9723.9490.2707.2556.2703.1512.3702
    12554.5774.6517.6801.2522.9785.6543.9765.6
    13492.2802.5433806.9550.4722.7524.9687.4
    14541.2713.3511.7756.2504.1737.1495.1705.3
    15439.3801.3496.6741.6555728.2526.8716.6
    16458759.1425733.3518.8846.1576.5799.4
    17516.4742.4485.9802.4462.2750.8487.5686.2
    18484.8707465.3756.8452.7830.1469.1775.4
    19427.4794.4417.4782.9584.3685.1583.1666.1
    20462.4747.4418.8798.2555.3869.6589.7820.3
    • Note:—FA values (×10−3); ADC values (mm2/s).

    • View popup
    Table 3:

    Comparison of diffusion characteristics between patient and control groups

    Patient GroupControl GroupP
    Mean FACS (×10−3)463.45 ± 43.14.0008a
    Mean ADCCS (mm2/s)786.50 ± 49.20751.55 ± 56.91.0043a
    • Note:—Values are presented as the mean ± SD.

    • ↵a Significant difference between groups (P <.05).

    • View popup
    Table 4:

    Interhemispheric comparison of diffusion characteristics

    Patient GroupControl Group
    H-TTPdelayedH-TTPshorterRt.Lt.
    In each group
        Mean FACS (× 10−3)445.77 ± 35.09481.13 ± 43.93499.03 ± 45.85498.09 ± 48.46
        P<.0001a.8682
        Mean ADCCS (mm2/s)800.12 ± 51.52772.89 ± 43.86753.68 ± 64.75749.43 ± 49.47
        P.0022a.5709
    Asymmetric index
        AIFA0.075 ± 0.040.0023 ± 0.04
        P<.0001a
        AIADC0.034 ± 0.040.004 ± 0.04
        P.0294a
    • Note:—Values are presented as the mean ± SD.

    • ↵a Significant difference between groups (P <.05).

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American Journal of Neuroradiology: 32 (10)
American Journal of Neuroradiology
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1 Nov 2011
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Changes in Integrity of Normal-Appearing White Matter in Patients with Moyamoya Disease: A Diffusion Tensor Imaging Study
H. Jeong, J. Kim, H.S. Choi, E.S. Kim, D.-S. Kim, K.-W. Shim, S.-K. Lee
American Journal of Neuroradiology Nov 2011, 32 (10) 1893-1898; DOI: 10.3174/ajnr.A2683
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H. Jeong, J. Kim, H.S. Choi, E.S. Kim, D.-S. Kim, K.-W. Shim, S.-K. Lee
Changes in Integrity of Normal-Appearing White Matter in Patients with Moyamoya Disease: A Diffusion Tensor Imaging Study
American Journal of Neuroradiology Nov 2011, 32 (10) 1893-1898; DOI: 10.3174/ajnr.A2683

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